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IDCU HomeInfectious Diseases A-C
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Infectious Disease Control Unit
Mail Code: 1960
PO BOX 149347 - Austin, TX 78714-9347
1100 West 49th Street, Suite T801
Austin, TX 78714
Phone: 512 776 7676
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CRE Home
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Last updated December 08, 2015
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Organisms, Causative Agent, or Etiologic Agent
Carbapenem-Resistant Enterobacteriaceae (CRE)
CRE, which stands for Carbapenem-resistant Enterobacteriaceae, are a part (or
subgroup) of Enterobacteriaceae that are difficult to treat because they are
resistant to commonly used antibiotics. Occasionally CRE are completely
resistant to all available antibiotics. CRE are an important threat to public health.
Enterobacteriaceae are a family of bacteria that include Klebsiella species and
Escherichia coli (E.coli), which are found in normal human intestines (gut).
Sometimes these bacteria can spread outside the gut and cause serious infections,
such as pneumonia, bloodstream infections, urinary tract infections, wound
infections, and meningitis. Enterobacteriaceae are one of the most common causes
of bacterial infections in both healthcare and community settings. Carbapenem are
a type of antibiotic frequently used to treat severe infections.
Transmission
To get a CRE infection, a person must be exposed to CRE bacteria. CRE bacteria
are most often spread person-to-person in healthcare settings through contact with
infected or colonized people, particularly contact with wounds or stool. CRE can
cause infections when they enter the body, often through medical devices like
intravenous catheters, urinary catheters, or through wounds caused by injury or
surgery.
Symptoms
Enterobacteriaceae cause many types of infections, such as pneumonia, urinary
tract infections, and bloodstream infections. Infections caused by CRE are harder
to treat because the bacteria are very resistant to antibiotics.
Prevention
To prevent the spread of CRE, healthcare personnel and facilities can follow
infection control precautions provided by CDC. These include:
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Washing hands with soap and water or an alcohol-based hand sanitizer before and after
caring for a patient
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Carefully cleaning and disinfecting rooms and medical equipment
Wearing gloves and a gown before entering the room of a CRE patient
Keeping patients with CRE infections in a single room or sharing a room with someone
else who has a CRE infection
Whenever possible, dedicating equipment and staff to CRE patients
Removing gloves and gown and washing hands before leaving the room of a CRE patient
Only prescribing antibiotics when necessary
Removing temporary medical devices as soon as possible
Sometimes, hospitals will test patients for these bacteria to identify them early to
help prevent them from being passed on to other patients.
As a patient you should:
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Tell your doctor if you have been hospitalized in another facility or country
Take antibiotics only as prescribed
Expect all doctors, nurses, and other healthcare providers to wash their hands with soap
and water or an alcohol-based hand rub before and after touching your body or tubes
going into your body. If they do not, ask them to do so.
Clean your hands often, especially:
o before preparing or eating food
o before and after changing wound dressings or bandages
o after using the bathroom
o after blowing your nose, coughing, or sneezing
Ask questions. Understand what is being done to you, the risks and benefits.
School Exclusion
CRE infections are rare in children. Unless directed by a physician, students with
any type of CRE wound infection need to be excluded from attending school until
drainage from wound or skin and soft tissue infection is contained and maintained
in a clean, dry bandage. Restrict a child from activity that could result in the
infected area being touched by others or becoming exposed, wet, soiled, or
otherwise compromised.
Texas Trends
Carbapenem-resistant Enterobacteriaceae has been found in Texas. The
prevalence of CRE remains unknown.